Simple Cardiovagal and Adrenergic Function Tests in Carotid Artery Stenosis Patients As a Potential Tool for Determining a Transient Autonomic Dysfunction

Overview

Journal Clin Auton Res

Date 2015 Sep 17

PMID 26374301

Citations 1

Authors

Viktor Svigelj

Matjaz Sinkovec

Viktor Avbelj

Roman Trobec

Affiliations

Soon will be listed here.

Abstract

Purpose: The arterial baroreflex depends on the integrity of the afferent limb, which can be quantified using the baroreceptor's sensitivity (BRS) during the Valsalva maneuver (VM). The aim of this study was to evaluate, using autonomic nervous system tests, the autonomic function in patients after a carotid artery angioplasty (CAS).

Methods: We evaluated the changes in blood pressure (BP) during the VM (Valsalva ratio, BRS, sympathetic indexes) in 41 patients with symptomatic, unilateral, internal carotid artery stenosis.

Results: The Valsalva ratio between the baseline and the post-procedural day (1.3 ± 0.1 vs 1.44 ± 0.3; P = 0.002) and the post-procedural day and a month later (1.44 ± 0.3 vs 1.3 ± 0.3; P = 0.0002) revealed significant differences. This was confirmed with a cardiovagal BRS test. However, the adrenergic BRS did not reveal any differences. Sympathetic indexes [BP fall (SI1) and recovery during phase 2 (SI2)] showed differences for the periods before and a day after the treatment (36.9 ± 18.0 vs 27.2 ± 21.4 and 7.1 ± 13.1 vs 3.0 ± 8.2, respectively; P = 0.004) and for SI1 a day and a month after the treatment (27.2 ± 21.4 vs 37.1 ± 21.8; P = 0.036). The dynamic ranges between S1 and S3 (the difference in the BP between the baseline and the end of phase 2) were also different (P = 0.007 and P = 0.044, respectively).

Conclusion: We found heterogeneous responses in the BP regulation obtained with the Valsalva maneuver in our patients; however, we could not confirm that CAS provoked any long-term autonomic dysfunction, except for 1 day after the procedure.

Citing Articles

Cardiovagal and adrenergic function tests in unilateral carotid artery stenosis patients-a Valsalva manoeuvre tool to show an autonomic dysfunction?.

Svigelj V, Sinkovec M, Avbelj V, Trobec R, Gaspar L, Petrovic D Wien Klin Wochenschr. 2016; 128(13-14):504-12.

PMID: 26980215 DOI: 10.1007/s00508-016-0980-2.

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